目的 本研究用微生态制剂、肠内营养制剂及二者联合对200名有营养风险的复治肺结核患者(tuberculosis,TB)进行辅助治疗,对比治疗前后指标变化,阐述三种营养治疗的改善作用.方法 收集2018年6月至2019年6月黑龙江省传染病院200例有营养风险的复治TB患者,随机分为自由营养组、肠内营养组、微生态制剂组、肠内营养联合微生态制剂组,组间一般情况、营养状况无统计学差异.经1个月抗结核治疗及营养治疗后再测量指标进行统计.结果 ①各指标在四组患者刚入院时组间无统计学差异(P>0.05);②治疗一个月后各指标在四组组间比较无差异(P>0.05);③治疗一个月后,各组组指标分别与刚入院时比较:在微生态制剂组、肠内营养组及二者联合组中,血中磷、镁含量显著上升(P<0.05),其他指标组内比较无差异(P>0.05).结论 微生态、肠内营养制剂及二者联合对复治TB患者血清磷、镁有提高作用,可改善患者营养状况.

Objective To investigate the relationship between serum levels of interleukin-12 (IL-12),Chemokine cytokines ligand 1 (CCL1) and type 2 diabetes mellitus complicated with tuberculosis (T2DM-PTB).Methods From September 2014 to June 2015 in the Infectious Hospital of Heilongjiang Province,40 cases of T2DM-PTB patients (group T2DM-PTB),40 cases of T2DM patients (group T2DM),and 40 healthy people (control group) were selected as the research objects.The demographic characteristics of the subjects were collected.In addition,3 to 4 ml venous blood was collected in the early morning.The serum levels of IL-12 and CCL1 were measured by enzyme-linked immunosorbent assay and compared among groups.Results The serum concentrations of IL-12 in the control group,T2DM group and T2DM-PTB group were (9.87± 2.75) μg/L,(11.25 ± 1.99) μg/L and (13.33±3.67) μg/L,respectively.The difference among the three groups was significant (F=4.46,P＜ 0.01).The serum levels of CCL1 in the control group,T2DM group and T2DM-PTB group were (158.03 ± 29.21)μg/L,(245.02±33.04) μg/L and (381.60±29.99) μg/L,respectively.The difference among the three groups was significant (F=267.90,P＜0.01).The serum levels of IL-12 and CCL1 in the T2DM and T2DM-PTB groups were significantly higher than that in the healthy control group,and the serum levels of IL-12 and CCL1 in the T2DM-PTB group was significantly higher compared with the T2DM group (P＜0.05).Conclusion The serum levels of IL-12 and CCL1 in patients with T2DM-PTB were significantly increased,suggesting their roles in the pathogenesis of T2DM-PTB.

目的：研究老年PCI术后患者血清在诱导人脐静脉内皮细胞损伤中的作用。方法：以人脐静脉内皮细胞ECV304为研究对象，实验分为6组：空白对照组、阴性对照组、12h、24h、48h、72h患者血清组。采用TUNEL法检测各组细胞凋亡率，采用ELISA法测定各组细胞细胞IL-1和IL-6的含量。结果：分别用PCI术后12h、24h、48h和72h患者血清处理ECV304细胞24h和48h后，可使细胞凋亡率显著增加，IL-1和IL-6显著增加，其中以48h患者血清处理ECV304细胞24h效果最为显著（P<0.05）。结论：老年PCI术后患者不同时间血清可诱导ECV304细胞损伤，以术后48h患者血清处理ECV304细胞24h后最为明显。此细胞模型的建立为进一步研究老年PCI术后患者缺血再灌注损伤的发病机制和防治提供实验基础。

目的：探讨MSCT在肺硬化性血管瘤诊断中的应用价值。方法收集12例经过病理证实的PSH患者CT及临床资料。结果平扫呈单发的孤立性圆形或类圆形肿块12例，合并瘤周钙化3例，晕征5例，空气半月征2例，血管贴边11例。平扫CT值为（17.2±6.3）HU，增强扫描延迟60 s时CT值为（85.3±10.1）HU，120 s时CT值为（101±9.6）HU，呈中等程度以上进行性持续强化改变。结论 MSCT在肺硬化性血管瘤的诊断中具有重要意义，可为临床制定治疗方案提供可靠依据。

OBJECTIVE:To study the effects of vitamin E succinate(VES) on proliferation,apoptosis and expressions of associated protein of human esophageal carcinoma cell line Eca-109 and TE-1.METHODS:Eca-109 and TE-1 human esophageal carcinoma cells were culturedin vitro. Cells were treated with different concentrations of VES for 24 h. MTT was used to measure the proliferation of cells. Morphological changes of cells were examined by inverted microscopy. Apoptosis was assessed by DAPI staining. The expression of poly ADP-ribose polymerase(PARP) of two cell lines among different concentration groups was examined by Western blotting.RESULTS:The inhibitory rate increased gradually with increasing concentration of vitamin E succinate (P<0.05). The number of dead cells decreased with increasing concentration of VES. Apoptosis appeared in different degrees in cellswith increasing concentration of VES. The cleavage of PARPprotein in two cell lines also increased gradually.CONCLUSION:Vitamin E succinate could inhibit proliferation and induce apoptosis of Eca-109 and TE-1 cell lines.

Objective To study rosuvastatin improve the endothelial function on endothelial cells of insulin resist-ance,and the mechanisms to confront atherosclerotic endothelial cells. Method Rosuvastatin as study drug,to estab-lish endothelial cells insulin resistance mode with cell culture,using nitroreductase method for the determination of the content of nitric oxide,using radioimmunoassay for endothelin levels,using western blot to observe the expression of nitric oxide synthase and quantitative analysis. Result Rosuvastatin acting on insulin resistance endothelial cells after 48h,there was a significant difference on NO increasing and ET-1 lowering(P<0. 05);compared with the con-trol group,rosuvastatin significantly increased the intracellular eNOS content(P<0. 05),the optimal concentration of rosuvastatin statin was 10-3 mmol/L. Conclusion Rosuvastatin improve endothelial function of insulin resistance en-dothelial cells significantly,the mechanism may be improving eNOS activity,leading to an increased of NO content and improving endothelial function.

结核病是当今最严重的传染病之一.结核病与糖尿病关系密切,糖尿病患者被认为是结核病易感人群之一,以病情进展快、疗效差、耐药性高、预后凶险为特征的糖尿病合并肺结核患者的大量出现,给治疗和控制带来了新挑战.笔者针对某些脂肪因子的改变与糖尿病及结核病的关系进行综述,目的在于加深对糖尿病合并肺结核发病机制的认知,从而对于这类患者的早期诊断及治疗、控制疾病进程,以及提高治愈率起到积极作用.

目的 对运用三维CT后处理成像系统确定眼内异物位置的临床应用价值进行探讨.方法 回顾性分析黑龙江省医院近3年就诊的眼内异物患者,共47例(48只眼)经眼眶三维CT检查并经过后处理成像技术处理的临床资料.47例(48眼)眼内异物伤患者中,9例(10眼)为眶内异物(包括眶壁异物),38例为球内异物,包括前房异物、晶状体、玻璃体、以及视网膜异物等,其中金属异物41例,非金属异物6例7眼.结果 三维CT后处理成像系统对眼内异物定位准确率100％.结论 三维CT后处理成像系统对眼内异物定位诊断有重要的临床应用价值.

目的：探讨分析应用双源flashCT冠状动脉血管成像技术诊断冠心病的临床价值。方法：选取2012年1月至2014年5月间我院收治的冠心病患者62例作为研究对象，分别应用CAG和双源flashCT冠状动脉血管成像技术为其进行检查，观察对比两种方法的检查结果，并将对比的结果及所有患者的临床资料进行回顾性的分析。结果：62例患者的冠脉CAG图像显示清晰，冠脉CTA均获得满意的血管图像重建。在这62例患者中，共有248支血管、930个节段参与了检查。冠脉CAG检查结果显示，存在冠状动脉狭窄的血管共有152支（包括RCA 45支、LM 20支、LAD 66支、LCX 21支）；双源flashCT冠状动脉血管成像检查结果显示，存在冠状动脉狭窄的血管共有167支（包括RCA 49支、LM 22支、LAD 70支、LCX 26支）。双源flashCT冠状动脉血管成像检查的敏感性为98%，特异性为90%，阳性预测值为91%，阴性预测值为98%，其检查结果与冠脉CAG检查结果相比无显著差异（P＞0.05），不具有统计学意义。结论：双源flashCT冠状动脉成像检查与CAG检查有着良好的一致性，可作为冠心病的有效筛查手段，具有十分重要的临床应用价值。

目的 探究应激性高血糖对老年急性冠脉综合征的预后影响.方法 将我院诊治的120例老年急性冠脉综合征患者,按照入院时血糖检测结果,分为A组(＜7.8 mmol/L)60例、B组(7.8 mmol/L～11.1 mmol/L)28例、C组(＞11.1 mmol/L)32例,回顾性分析三组患者的临床资料,对比三组患者的预后状况.结果 随着血糖水平的上升,心力衰竭、心源性休克、恶性心律失常、心功能≥Ⅲ级等发生率及血清心肌肌钙蛋白Ⅰ(cTnⅠ)、N末端脑钠肽前体(NT-proBNP),均呈逐渐升高趋势,其中,C组心力衰竭、心源性休克、恶性心律失常、心功能≥Ⅲ级等发生率及cTnⅠ、NT-proBNP等指标水平均显著高于A组,差异均有统计学意义(P＜0.05);C组住院期间死亡率为21.88％,显著高于A组1.67％、B组3.57％,差异均有统计学意义(P＜0.05).结论 应激性高血糖可提示老年急性冠脉综合征患者的预后状况不良,当血糖水平＞11.1 mmol/L时,患者的死亡风险增加.

目的：探讨分析急性冠脉综合症合并应激性高血糖的相关危险因素。方法以该院2012年3月—2014年3月收治的96例急性冠脉综合症患者为研究对象，将60例未合并应激性高血糖患者视作对照组，36例合并应激性高血糖患者视作观察组，应用单因素和多元Logistic回归法分析应激性高血糖的危险因素。结果观察组不良心血管事件发生率36.11%，对照组不良心血管事件发生率13.33%，组间比较差异有统计学意义（P<0.05)；单因素分析结果提示两组患者年龄、性别、体重指数和心功能比较差异有统计学意义（P<0.05)，高血压、高血脂、吸烟和住院时间比较差异无统计学意义（P>0.05)；多元Logistic回归分析提示年龄、性别和心功能均是急性冠脉综合症并发应激性高血糖的危险因素。结论应激性高血糖可能是急性冠脉综合症预后不良的标志，高龄、女性和心功能下降明显的患者更容易合并应激性高血糖。

1一般资料 患儿,女,4岁,于17月大时曾因突然不能站立行走就诊,当时查头部MRI示颅脑无明显改变.查体时发现左锁骨上有一软组织样肿物,疑似来源于胸腔,查胸部CT(组图1)见左上纵膈占位性病变,考虑恶性肿瘤,左肺下叶结节影,考虑转移瘤.淋巴结活检病理诊断:转移性小圆细胞肿瘤,倾向神经外胚层肿瘤.当时临床评估患儿继续生存时间为2-3个月,干预治疗风险极大且预后差,遂家长未接受任何干预治疗措施.于2个月后患儿逐渐运动恢复自行站立行走,且左锁骨上肿物自行逐渐减小消退,2岁时该患儿运动语言等发育同正常同龄儿,无症状继续生存.

目的：探讨影像学检查在眼部异物定位诊断的临床研究。方法：回顾性分析黑龙江省医院近3年就诊并行手术眼部异物取出的眼内异物患者，共46例（47只眼）经眼科及影像学检查进行异物定位的临床资料。46例（47眼）眼内异物伤患者中，8例（9眼）为眶内异物（包括眶壁异物），38例为球内异物，包括前房异物、晶状体、玻璃体、以及视网膜异物等，其中金属异物40例，非金属异物6例7眼。结果：眼科检查及影像学检查对眼部异物进行定位诊断各有适应症，其中三维CT后处理成像系统对眼内异物发现及定位准确率最高，其次是眼部B超，UBM对眼前部异物发现及定位准确率最高。结论：采用三维CT后处理成像系统对眼内异物进行定位诊断为主，与其他检查联合对异物行定位诊断对手术有重要的指导意义。

目的：分析冠状动脉狭窄性病变与其相应供血心肌节段有无灌注异常的相关性。方法41例临床拟诊或确诊冠心病患者行双源CT冠状动脉成像(CTCA )及单光子发射计算机断层成像( SPECT)心肌灌注显像( MPI)。结果CTCA狭窄50%时，诊断心肌灌注异常的准确性为85%，特异度为87%，敏感度为78%，阴性预测值为91%，阳性预测值为71%；以MPI为标准。。结论冠脉病变的狭窄程度与相应供血心肌节段灌注异常密切相关，双源CT一站式检查对冠心病的诊断、治疗及预后评估具有重要意义。

Objective To evaluate clinical application value for the 64-slice spiral CT in the diagnosis of lower extremity arterial disease.Methods Randomly selected lower limb arterial CTA examination 33 patients in two years,the diagnosis analysis,focused on lower extremity arterial stenosis and occlusion.Results The retrospective analysis of 31 patients,diagnostic positive rate was 100%,unilateral iliac artery disease found 20 cases(occlusion in 3 cases),bilateral lesions in 11 cases(occlusion 1 case);unilateral femoral artery lesions in 31 cases(occlusion 7 cases),bilateral lesions in 23 patients(occlusion in 2 cases);popliteal artery with unilateral lesions in 8 cases(occlusion 1 case),bilateral lesions in 2 cases.Conclusion 64-slice spiral CT angiography fast,simple,safe,easy to be patient receives,from the multi-faceted,multi-perspective subjects blood vessels,but also has some of ionizing radiation,and can not observe the flow direction and phase,shows small blood vessels less than ideal.

16排螺旋CT具有各项同性、极快的扫描速度、超薄层厚等优势,能显示更小的血管分支,在腹部血管成像方面较早期的多层螺旋CT具有更大优势.本研究对43例患者行肝脏16排螺旋CT双期扫描,旨在探讨对肝脏块鉴别诊断的价值.

Objective: To determine the value of 64-slice CT in diagnosis of lower extremity arterial disease. Methods: A total of 22 cases of lower extremity arterial disease clinically confirmed were selected and their imaging manifestations were analyzed. Results: The 64-slice spiral CT has more advantages for diagnosing lower extremity arterial disease. Conclusion: Use of the equipment improves the rate of correct diagnosis of the disease.

Objective: To determine the significance of screening parameters in 16 spiral CT for diagnosis of acute stroke. Methods: Proper scanning parameters were set up and perfusion CT software used to obtain related parameters (relative cerebral blood flow, relative brain blood volume peak time) by creating image of cerebral blood flow (CBF), cerebral blood volume (CBV) and peak time by two doctors independently. Results: Sensitivity and accuracy Of checking potential ischemic type and scope by perfusion CT reached 90% and 100%, respectively. Conclusion: Perfusion CT can assist doctors to evaluate cerebral perfusion distribution type and scope.

腰椎间盘突出症是骨伤科临床中的常见病、多发病,目前临床治疗以针灸推拿等保守治疗为主[1].随着科学技术的发展,在CT引导下采用臭氧消融术治疗腰椎同盘突出症越来越受到临床重视.笔者采用此法治疗腰椎问盘突出症患者62例,获得良好效果,现报告如下.

Objective To explore clinical application of coronary artery imaging with 64-slice spiral CT.Methods 46 patients with coronary heart disease were undergone both coronary artery imaging with 64-slice spiral CT and coronary angiography,and the effects on coronary display respectively were compared Results Coronary display in coronary artery imaging with 64-slice spiral CT was better than that of the coronary angiography, which was a inspection pattern of noninvasive coronary display. Conclusion Coronary artery imaging with 64-slice spiral CT can accurately evaluate coronary artery stenosis, which was worth to application.